Form M - 4/97

I hereby apply for membership in the INSTITUTE as
Professional Graduate Associate

Referees : Please provide the names of two persons who know you, are aware of your achievements and are willing to support your application. At least one of these referees must be a MIFT professional member. (Please advise if you do not know anyone who is a MIFT professional member).

Academic Training :

Major field of study

Agriculture Biological Science Chemistry Chemical Engineering

Diary Science/Technolgy Engineering (other than chemical) Food Science/ Technolgy

Home Economics Microbiology Others (Specify)

Employment Experience (List Present Employer First)

Other Relevant Information

I, the undersigned, declare the foregoing information to be true and correct to the best of my knowlegde. I hereby apply for membership, and undertake, if admitted, to comply with the MIFT Constitution, Bye-Laws, and the code of professional conduct, and to pay the prescribed fees.

For Official Use

Membership Class : P G A

YOUR BUSINESS INTEREST & RESPONSIBILITIES

I. AREAS OF FUNCTIONALITY RESPONSIBILITY - Please select your Primary Function (!-F) - ONE ONLY, and tick the boxes (Number 1-39) all other specific functions/areas which also describe your work.

NOTE : SELECT ONE PRIMARY FUNCTION (A-F) AND CHECK OTHERS THAT APPLY.

A. RESEARCH & DEVELOPMENT

01. Product Development (Consumer)
02. Product Development (Food Service/Institutional)
03. Product Development (Industrial)
04. Product Development/Engineering
05. Quality Assurance
06. Sensory Evaluation
07. Basic Research
08. Packaging Research & Development

B. MANAGEMENT

09. Corporate
10. Scientific/Technical
11. Plant

C. CONSULTING AND OTHER SERVICES

12. Technical/Scientific
13. Management Consulting
14. Independent Testing Laboratory
15. Legal Consulting
16. Contract Packaging and Processing
17. Personnel Recruitment & Placement
18. Scientific/Trade Association
19. Publisher
20. Information Services
21. Other (Specify)

D. MARKETING

22. Sales/Marketing
23. Technical Sales/Service
24. Broker
25. Promotion/Advertising

E. EDUCATION

26. Administration
27. Extension Services
28. Teaching/Searching
29. Graduate and Post-Graduate Student
30. Undergraduate Student

F. GOVERNMENT

31. Regulatory (Federal)
32. Regulatory (State)
33. Regulatory (Local)
34. Inspection (Federal)
35. Inspection (State)
36. Inspection (Local)
37. Research & Development (Federal)
38. Research & Development (State)
39. Research & Development (Local)

II. MAJOR AREAS OF INTEREST WITHIN FUNCTIONAL RESPONSIBILITY .
Tick all that apply.

40. Food Additives/Ingredients (excluding flavours)
41. Food Flavors
42. Nutrition
43. Toxicology/Food Safety
44. Microbiology
45. Physical Properties
46. Environmental Pollution
47. Packaging
48. Processing Pilot Plant Equipment Design & Development
49. Facility Design and Construction (Laboratory, Plant Warehouse, etc)
50. Laboratory Instrumentation Design and Development
51. Other (Specify)

III. TITLE - (Please print your job title or titles)

a.

b.

c.

YOUR ORGANISATION'S PRODUCTS OR SERVICES - Please look at the major headings on this page and place a tick showing the listing of products/services which your ORGANISATION produces/provides.

PRODUCTS

101. Bakery Products
102. Beverages (Alcoholic, Non-alcoholic, Coffee, Tea, etc)
103. Canned and/or Frozen Fruits and Vegetable
104. Confectionary Products
105. Diary Products
106. Egg and Egg Products
107. Fats and Oils
108. Fish and/or Shellfish Products
109. Fresh Fruits and/or Vegetables
110. Grain Mill Products (Breakfast Cereals, Flours, Starches, etc)
111. Pasta Products (Wheat/Rice Noodles, Macaroni, Spaghetti, etc)
112. Meat Products
113. Pet Foods (Dog, Cat, and other pet foods)
114. Poultry and Poultry Products
115. Snack Foods
116. Culinary Sauces (Tomato, Chilli, Oyster and Soya Sauces, etc)
117. Chilled/Frozen Confectionary or Bakery Products

PROCESSING, PACKAGING AND LABORATORY EQUIPMENT AND SUPPLIES

118. Food Processing and Packaging Equipment and Supplies
119. Food Service Preparation and Packaging Equipment and Supplies
120. Laboratory Equipment and Supplies
121. Processing Instruments (Controlling, Indication and Recording)

INGREDIENT AND/OR ADDITIVES

122. Acidulants
123. Anticaking Additives
124. Antifoaming Additives
125. Antimicrobal Additives
126. Antioxidant Additives
127. Bakery Product Additives (Dough Conditioners & Improvers,Flour Bleaching & Maturing Agents, etc)
128. Colors (Cerified, Natural)
129. Curing Agents
130. Emulsifers and/or Surfactants
131. Enzymes (including Meat Tenderizers)
132. Flavors (Natural and/or Synthetic)
133. Flavors Enhancers (including MSG, Nucleotides, etc)
134. Gums and other Hydrocolloids
135. Humectants
136. Proteins and Proteins Products
137. Sweeteners (Nutritives and non-Nutritives)
138. Vitamins, Minerals, and other Nutrient Supplements
139. Other Food Activities and/or Ingredients Not Listed Above
140. Seasonings and Spices

SERVICES

141. Analytical and/or Testing Laboratory Services
142. Contracting Processing and/or Packaging
143. Management Consulting Services
144. Technical Consulting, R&D, Product/Process Development Services
145. Other Products and/or Services Not Listed Above
146. Education and/or Information Services
147. Government Regulatory, Inspection and/or R&D Services
148. Food Services, Hospitals, Restaurants, Schools, etc

Kindly complete the above information and send together with a copy of passport size photo to :

Malaysian Institute of Food Technology
45, Jalan SS 15/4B, 47500 Subang Jaya, Selangor, Malaysia